COURSE SYLLABUS RT 1145 RADIOGRAPHIC POSITIONING FILM CRITIQUE & MEDICAL TERMINOLOGY I

Transcription

1 COURSE SYLLABUS RT 1145 RADIOGRAPHIC POSITIONING FILM CRITIQUE & MEDICAL TERMINOLOGY I CLASS HOURS: 4 CREDIT HOURS: 4 LABORATORY HOURS: 5 CATALOG COURSE DESCRIPTION: This course is the first of a three-course sequence in the fundamentals of radiographic positioning and procedures and medical terminology applied to Radiologic Technology. The complete sequence provides the opportunity for a student to develop the knowledge and skills necessary to perform the routine radiographic examinations of the skeletal system, soft tissue structures, and common contrast procedures such as GI, IVP, BE and cholangiography. The origin of medical terminology are set forth and a word building system is introduced. Abbreviations and symbols are addressed. Understanding radiologic orders and diagnostic reports is emphasized. Topics covered in the first course include: introduction to radiographic positioning and terminology, upper extremities, lower extremities, bony thoracic and lumbar-lumbosacral vertebrae. Laboratory assignments provide the student the opportunity for simulation and practice of the examinations prior to working with patients. ENTRY LEVEL STANDARDS: High School and college achievement, test scores, relevant work experience, and true desire to become a radiologic technologist shall be consistent with the Radiologic Technology program admission requirements. Since building a vocabulary is a highly individualized endeavor, the student should demonstrate a responsible attitude toward independent learning activities. Also, the student should demonstrate a responsible attitude toward attendance and class participation and preparation. PREREQUISITE: Admission to the Radiologic Technology Program COREQUISITE: RT 1130, BIOL 2010 TEXTBOOK(S) AND OTHER REFERENCE MATERIAL BASIC TO COURSE: 1. Merrill s Atlas of Radiographic Positions & Radiologic Procedures, Ballinger 2. Workbook and Laboratory Manual, Volume I, Bontrager 3. Pocket Ballinger 4. Exploring Medical Language A Student Directed Approach, LaFleur and Starr, Mosby, elearn e-pack Required Student Learning Outcomes (Program Student Learning Outcomes and Course Student Learning Outcomes): (PSLO 1-9 are covered in different courses. If a PSLO is not identified here it is not addressed in this course.) PSLO#1. Provide basic patient care and comfort, well-being, safety, procedural materials appropriate to quality care and exam performance using proper sterile or aseptic technique to prevent contamination of patients, self, sterile trays, instruments or fields. CSLO# 12 Given radiographic requests or diagnostic reports, demonstrate the ability to correctly translate them. (I) PSLO#3. Apply knowledge of human anatomy, physiology, pathology, positioning and radiographic technique to demonstrate anatomical structures on a radiograph or other imaging receptor utilizing equipment and accessories while maintaining the overall diagnostic quality of radiographs. CSLO# 1 Demonstrate knowledge of positioning anatomical terminology and anatomy of the portions of the body covered. (I, II, IV, VIII) CSLO# 2 Given simulated situations which apply to the following topics, identify or describe accepted professional practice: (IV, V, VI, and VIII) 1. Evaluation of radiographic orders 2. Room preparation 3. Patient care and management 4. Condition of patient CSLO# 3 Following the criteria below, demonstrate knowledge of and perform radiographic positioning of the upper and lower extremities, the shoulder girdle, the pelvis and upper femora, the bony thorax, the chest,

2 the abdomen to include common contrast examinations of the abdominal organs and the spine. (I, II, IV, and VIII) 1. Part a. position of body b. structure(s) visualized and function(s) demonstrated 2. Film size / placement / identification and R and L Markers 3. Technique formulation / selection a. ma b. time c. kvp d. SID e. screen / film 4. Beam, film, patient alignment and CR angulation 5. Beam limitation / shielding radiation protection and film quality 6. Patient instructions a. respiration b. other CSLO# 4 Critique radiographs to determine proper positioning, collimation, protection, and structures shown for basic projections of the upper and lower extremities, shoulder girdle, pelvis and upper femora, bony thorax, chest, abdomen and spine. (III, VIII) CSLO# 5 Given diagrams, anatomic structures or radiographs, identify and/or locate component parts. (I) CSLO# 6 Locate anatomy from the standpoint of the topography of anatomy and explain the relationship of organs to each other. (I) PSLO#6. Use acceptable verbal, nonverbal and written medical/conventional communication in patient care intervention and professional relationships in order to promote positive experiences for patients, peers and staff. CSLO# 7 Demonstrate knowledge of word parts and rules for combining those parts into meaningful medical terms. (I) CSLO# 8 Demonstrate the ability to analyze and define medical terms relative to the structure and function of the body. (I) CSLO# 9 Demonstrate the ability to build, analyze, define, pronounce and spell the terms related to each of the following systems: 1. Integumentary system 2. Respiratory system 3. Cardiopulmonary and lymphatic systems 4. Digestive system 5. Musculoskeletal system CSLO# 10 Demonstrate the ability to analyze, define, pronounce and spell the terms related to direction, planes and regions, and body positions. (I) CSLO# 11 Recognize commonly used abbreviations. (I) Other Learning Indicators or Objectives (optional): The student will be able to: Terminology (A) *75% Minimum Mastery Level Required 1. Define the following terms used to describe body positions or planes: 1) decubitus a. dorsal b. ventral c. left lateral d. right lateral 2) recumbent a. dorsal b. lateral c. prone or ventral 3) prone

3 4) supine 5) anatomic position 6) sagittal plane 7) coronal plane 8) transverse plane 2. Define the following standard terms used to describe part, location, or position: 1) anterior 11) medial or mesial 2) ventral 12) parietal 3) dorsum or dorsal 13) peripheral 4) central 14) posterior 5) distal 15) plantar 6) external 16) superior 7) inferior 17) cranial 8) caudal 18) cephalic 9) internal 19) proximal 10) lateral 20) visceral 3. Define the following terms of positioning: 1) projection 2) view 3) method (example Towne) 4) lateral position, projection 5) RAO position, projection 6) LAO position, projection 7) LPO position, projection 8) AP position, projection 9) PA position, projection 10) oblique position, projection 11) tangental projection 12) axial projection 13) decubitus position, projection 4. Define the following terms which are used to describe movement: 1) abduction 2) adduction 3) evert or eversion 4) extension 5) flexion 6) invert or inversion 7) pronate 8) supinate 5. Define the following anatomic terms which are used to describe processes or projections that extend beyond the main body of a structure: 1) condyle 2) coracoid 3) coronoid 4) crest 5) epicondyle 6) facet 7) head 8) malleolus 9) protuberance (process) 10) spine 11) styloid 12) trochanter 6. Define the following anatomic terms which are used to describe depressions or hollow areas of a structure: 1) fissure 2) foramen 3) fossa

4 4) groove 5) sinus 6) sulcus 7. Define the following 1) anatomy 2) physiology 3) long bones 4) diaphysis 5) epiphyses 6) short bones 7) flat bones 8) irregular bones 9) appendicular skeleton 10) axial skeleton 11) synarthrosis 12) amphiarthrosis 13) diarthroses General Positioning Considerations (B) *75% Minimum Mastery Level Required 1. State the importance of the following information found on the x-ray request for examination: a. patient identification and information b. procedure ordered c. clinical history d. patient symptoms 2. State the importance of the following a. room preparation b. patient / technologist interaction c. patient comfort and safety d. patient preparation e. patient monitoring f. caliper use g. radiation protection Medical Terminology (G, H) - 75% Minimal Mastery Level Required A. Introduction to Word Parts 1. Identify and define the four word parts. 2. Analyze and define medical terms. 3. Build medical terms for given definitions. B. Structure of the Human Body 1. Define the anatomical terms of the human body structure. 2. Give the definitions of the word parts included in this chapter. 3. Build, analyze, define, pronounce and spell the diagnostic terms related to the human body structure. 4. Build, analyze, define, pronounce, and spell additional terms related to the human body structure. 5. Define, pronounce, and spell the other additional terms related to the human body structure. Upper Extremity Positioning (B, C, D, E, F) A. Hand-Fingers - *75% Minimum Mastery Level Required 1. When given a drawing, skeletal part, or radiograph of the hand, label or locate the following bones and identify bones which articulate: a. phalanges 1) distal 2) middle 3) proximal b. metacarpals (1 st -5 th ) c. capitatum (os magnum) d. pisiform e. triquetrum (cuneiform)

5 f. lunate (semilunar) g. lesser multangular (trapezium) h. greater multangular (trapezium) i. navicular (scaphoid) j. radius k. ulna 2. State the type of screens which should be used for radiographic examinations of the hand and fingers. 3. State the routine projections commonly taken of the hand, fingers (2 nd -5 th ) and thumb. 4. Be able to discuss or answer questions concerning the following positioning considerations: a. part position (examples- AP, oblique, lateral or other) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 5. Describe the difference in structures demonstrated of a hand in lateral extension as opposed to a hand in lateral flexion. 6. List three reasons why most radiographic examinations of the skeletal system require a minimum of two projections 90 degrees from each other. 7. Explain the variation in exam procedure necessary when doing the extremity radiographic examinations portable, in surgery, or in an intensive care unit as opposed to in the department. 8. Describe the position of the thumb in a PA projection of the hand. B. Wrist *75% Minimum Mastery Required 1. State the type of screen used for an examination of the wrist. 2. State the routine projections commonly taken of the wrist. 3. Be able to discuss or answer questions concerning the following positioning considerations: a. part position (examples AP, oblique, lateral or other) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions s 4. Describe the difference in structures demonstrated in the PA and AP projections of the wrist. 5. State the purpose of the ulnar and radial flexion projections and identify the structures demonstrated in each. 6. Describe the difference in structures demonstrated in the posterior and anterior oblique projections of the wrist. 7. State the purpose of the carpal canal and carpal bridge tangential projections and identify the structures demonstrated in each. 8. Describe the purpose of the Stecher method to exam the wrist and discuss the variations of this method. 9. Explain the importance of the clenched fist when doing a radiograph of the wrist. C. Forearm 75% Minimum Mastery Level Required 1. When given a drawing, skeletal part or a radiograph of the forearm, label or locate the following bones: a. ulna 1) semilunar notch 2) coronoid 3) head 4) styloid 5) shaft 6) olecranon process b. radius

6 1) head 2) neck 3) tuberosity 4) shaft 5) styloid 2. State the type of screen used for an examination of the forearm. 3. Be able to discuss or answer questions concerning the following positioning considerations: a. part position (examples AP and lateral) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 4. Explain why the hand must be supinated for a frontal projection of the forearm. D. Elbow 75% Minimum Mastery Level Required 1. When given a drawing, skeletal part, or radiograph of the elbow, label or locate the following bones: a. ulna 1) semilunar notch 2) coronoid 3) olecranon process 4) radial notch b. radius 1) head 2) neck 3) tuberosity c. humerus 1) trochlea 2) capitellum 3) medial and lateral condyle 4) medial and lateral epicondyle 5) coronoid fossa 2. Be able to discuss or answer questions concerning the following positioning considerations: a. part position (examples AP, obliques, lateral) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 3. Explain why the hand must be supinated for an AP projection of the elbow. 4. Explain the purpose of oblique views of the elbow. 5. Contrast the radiologic examination of the partially and acutely flexed elbow with the routine AP and lateral projections of the elbow. 6. Explain the rationale for the following methods of x-ray examination to demonstrate the radial head. a. lateromedial rotation b. Lateral, CR angled 45 degrees c. Four-position Series 7. For an axial projection of the olecranon, explain the difference in structures demonstrated for the 90 degree as opposed to the 20 degree angulation of the CR. E. Humerus 75% Minimum Mastery Level Required 1. When given a drawing, skeletal part, or radiograph of the humerus, label or locate the following bones:

7 a. head b. greater tuberosity (tubercle) c. lesser tuberosity (tubercle) d. shaft e. medial condyle f. medial epicondyle g. trochlea h. capitellum i. lateral condyle j. lateral epicondyle k. coronoid fossa l. surgical neck m. anatomic neck n. bicipital groove 2. Be able to discuss or answer questions concerning the following positioning considerations: a. part position (examples AP, lateral, transthoracic lateral) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 3. For an AP and lateral projection of the humerus, describe the position of the coronal plane passing through the epicondyles in relation to the plane of the film. 4. Describe the variation in exposure factors when performing projections of the humerus bucky as opposed to non-bucky. 5. Describe the importance of correct part / film / grid / CR alignment when performing a humerus examination in the bucky. 6. State patient conditions that would indicate projections of the humerus being performed erect rather than recumbent and vice-versa. 7. Explain the breathing instructions which should be given to the patient when performing exams of the humerus and the reason for the special breathing instructions. 8. Associate the term Lawrence method with the transthoracic lateral projection of the humerus. 9. Identify patient conditions that would indicate performing a transthoracic lateral projection of the humerus instead of a routine lateral projection. 10. Contrast the anatomic definition seen in a radiograph of the upper humerus using the transthoracic lateral projection with the definition seen in the routine lateral or axial projection. 11. State the preferred patient position for the transthoracic lateral projection. 12. State the reason for instructing the patient to hold his breath on full inspiration instead of full expiration when using a non-breathing technique for the transthoracic lateral projection of the humerus. 13. When doing a transthoracic lateral projection of the humerus, explain the conditions under which an extended exposure time would be advisable. F. Shoulder Girdle (shoulder, clavicle, acromioclavicular articulations, and scapula) 75 Minimum Mastery Level Required 1. When given a drawing, skeletal part, or radiograph of the shoulder girdle, label, locate, or identify the following: a. clavicle 1) shaft 2) sternal extremity 3) acromial extremity b. scapula 1) axillary border 2) vertebral border 3) coracoid process 4) acromion 5) glenoid fossa

8 6) body 7) medial angle 8) infraspinatus Fossa 9) supraspinatus fossa 10) inferior angle 11) scapular notch 12) anterior surface 13) posterior surface 2. Be able to discuss or answer questions concerning the following positioning considerations. a. part position (examples AP, coracoid process and glenoid fossa, axial projection, acromioclavicular articulations, clavicle scapula) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 3. Identify patient conditions that would indicate performing radiologic examinations of the shoulder in the erect position as opposed to the recumbent position. 4. Describe the difference in structures demonstrated in the AP internal, external, and neutral projections of the shoulder. 5. State the special breathing instructions that should be given to the patient when radiographing the shoulder girdle and explain. 6. Describe the adjustment in exposure factors which is necessary when performing projections of the shoulder girdle bucky as opposed to non-bucky. 7. For an AP projection of the shoulder, explain the difference in structures demonstrated with a CR angulation of 90 degrees as opposed to a caudal angulation of 25 or 15 degrees. 8. Explain the centering and direction of the central ray and the position of the cassette for an AP axial projection of the coracoid process. 9. Explain the importance of rotating the body approximately 45 degrees toward the affected side when examining the glenoid fossa. 10. Associate the term Lawrence method with the inferosuperior axial projection of the shoulder. 11. Explain the significance of a 35 degree cephalic angulation (axial projection) of the shoulder. 12. Explain the rationale for placing the patient in an erect position when radiographing the acromioclavicular joints. 13. Define dislocation and subluxation. 14. Explain the significance of equal weight in each hand when examining the acromioclavicular joints. 15. Differentiate the Pearson method of A.C. joint demonstration with the Alexander methods. 16. Explain the significance of CR angulation when using Alexander s method of unilateral AP and lateral demonstration of the acromioclavicular articulations. 17. Identify the preferred position of the body when doing a clavicular x-ray examination. 18. Describe the indications for examination of the clavicle in the PA position. 19. Describe the position of the head for examination of the clavicle in the PA position. 20. Explain why a PA projection of the clavicle produces a more detailed view of the clavicle than the AP projection. 21. Explain the purpose and significance of an axial projection of the clavicle. 22. State the reason for requiring the patient to suspend respiration on full exhalation when radiographing the clavicle in the AP or PA projection. 23. State the reason for requiring the patient to suspend respiration on full inhalation when radiographing the clavicle in the AP axial projection. 24. Describe the position of the arm when radiographing the scapula in the AP projection. 25. State the reason for requiring the patient to continue normal breathing when radiographing the scapula in the AP projection. 26. Compare structures demonstrated of the scapula using the PA oblique projection (Lorenz method) with the structures demonstrated using the PA oblique projection (Lilienfeld method).

9 27. Describe the difference in arm and hand adjustment using the Lorenz method of scapula demonstration as opposed to using the Lilienfeld method. 28. When doing a lateral projection of the scapula, describe the variations in arm adjustment necessary to demonstrate 1) the scapular body, 2) the acromion and coracoid processes, and 3) the glenohumeral joint. 29. When examining the scapula in the AP oblique projections, describe the variations in arm adjustment which result in 1) an AP oblique demonstration, 2) an oblique lateral demonstration, and 3) a direct lateral demonstration. 30. Describe the two major reasons for examining the scapula in body positions other than the AP position. Medical Terminology (J) 75% Minimum Mastery Level Required A. Directional Terms, Anatomical Planes and Regions, and Body Position Terms 1. Define, pronounce, and spell the terms used to describe the body directions. 2. Define, pronounce, and spell the terms used to describe the anatomical planes. 3. Define, pronounce, and spell the terms used to describe the anatomical abdominal regions. 4. Define, pronounce, and spell additional terms related to the body. Lower Extremity Positioning (B, C, D, E, F) *1. Be able to discuss or answer questions concerning the following positioning considerations: (All positions of the Lower Extremities) - 75% Minimum Mastery Level Required a. part position (example AP, oblique, lateral, dorsoplantar) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions Foot Toes Ankle (75% Minimum Mastery Level Required) A. When given a drawing, skeletal part, or radiograph of the foot or ankle label or locate the following bones and identify bones which articulate 1. Foot a. phalanges (phalanx) 1) distal 2) middle 3) proximal b. metatarsals (1 st -5 th ) c. tarsus 1) internal of 1 st cuneiform 2) middle or 2 nd cuneiform 3) external or 3 rd cuneiform 4) cuboid 5) navicular or scaphoid 6) talus or astragalus 7) calcaneus or os calcis 2. Ankle a. talus b. tibia 1) medial malleolus c. fibula 1) lateral malleolus 3. Articular facets of calcaneus (subtalar joints) a. tuberosity b. anterior articular facet c. middle articular facet 1) floor of sinus tarsi

10 2) sustentaculum tarsi d. posterior articular facet 4. State the type of screens which should be used for radiographic examinations of the foot and ankle. 5. Describe the structures demonstrated when radiographing the toes in the three routine positions. 6. State why a 15 degree angle should be used when the toes are radiographed in the dorsoplantar projection and why no angulation is needed in the plantodorsal projection. 7. State which type of oblique projection of the toes will better demonstrate the phalanges and joint spaces. 8. Describe the structures demonstrated when radiographing the foot in the three routine positions. 9. State the difference in structures demonstrated in a dorsoplantar projection of the foot when a 10 degree angle (posteriorly) is used as opposed to no angulation of the C.R. 10. Compare structures demonstrated in the medial oblique view of the foot with structures demonstrated in the lateral oblique view of the foot. 11. State why the lateromedial projection of the foot is a more accurate projection than the mediolateral projection. 12. Explain the purpose of weight-bearing studies of the foot and describe the structures shown. 13. Explain the need for bilateral examination of the feet when doing weight-bearing, longitudinal arch studies. 14. State the point of centering of the film and CR in weight-bearing studies of the foot. 15. Explain the significance of equal distribution of weight on the feet for longitudinal arch studies. 16. Explain the significance of placing the sole (plantar surface) of the foot perpendicular to the plane of the film (horizontal) in examinations of the calcaneus. 17. Describe, locate, identify the component aspects of the calcaneus when it is shown in an axial and lateral projection. 18. Compare central ray angulation for a plantodorsal axial projection of the calcaneus with CR angulation for a dorsoplantar axial projection of the calcaneus. 19. State the relation of the malleolar plane to the plane of the film in an AP, oblique, and a lateral projection of the ankle. 20. Explain why the foot is flexed to place its long axis in the vertical position for each of the three projections of the ankle. 21. Explain the purpose of slight inversion of the foot, using care not to rotate the leg, in AP projections of the ankle. 22. Explain the importance of perfect centering over the ankle joint for all views of the ankle. 23. State the external bony prominence which is at the level of the ankle joint. 24. List two advantages to radiographing the ankle with the medial surface against the film rather than the more common practice of placing the lateral surface against the film. 25. List the three routine projections of a ankle. 26. Describe the structures shown in a medial oblique of the ankle. 27. Describe the procedure for performing an AP stress examination of the ankle and reason for performing such a study. 28. Describe the appearance of the ankle with a torn ligament in an AP stress study. 29. Identify the stress maneuver to test for rupture of 1) the lateral ligament and 2) the middle ligament of the ankle. Leg Knee Patella 75% Minimum Mastery Level Required A. When given a drawing, skeletal part, or radiograph of the leg, knee, patella, or femur label or locate the following bones and identify bones which articulate: 1. Leg a. tibia 1) spines 2) medial condyle 3) lateral condyle 4. tuberosity 5. shaft 6. medial malleolus b. fibula 1) styloid 2) head 3) shaft

11 4) lateral malleolus 2. Knee a. lower leg (proximal end) 1) tibial spines 2) styloid of fibula (not part of knee joint proper) 3) head of fibula (not part of knee joint proper) 4) lateral condyle (tibia) 5) medial condyle b. femur (distal part) 1) lateral condyle 2) medial condyle 3) lateral epicondyle 4) medial epicondyle 5) intercondylar fossa c. patella 1) base 2) apex 3) body B. Lower Leg (tibia and fibula) 1. State the two routine projections used to demonstrate the lower leg. 2. State the relation of the malleolar plane or the condylar plane to the plane of the film in an AP, oblique, and a lateral projection of the lower leg. 3. State the centering and direction of the central ray for the AP and lateral projections of the lower leg. 4. Describe the anatomic location of the tibia relative to the fibula. C. Knee / Patella / Femur 1. Describe the variation in exposure factors when performing projections of the knee bucky as opposed to nonbucky. 2. Explain the radiation protection measures taken for an examination of the knee or other lower extremity. 3. Describe the external bony prominence which is used to locate the knee joint. 4. State the relation of the intercondylar plane to the plane of the film in an AP, oblique, and a lateral projection of the knee. 5. Explain the reason for a 5 to 7 degree cephalad angulation of the CR when radiographing the knee joint in the AP/PA or lateral projection. 6. Describe the lateral and medial interspace of the knee joint if the AP or PA projection of the knee is correct. 7. State the degree of flexion of the knee normally used in lateral survey studies and explain the reason for the degree of flexion. 8. State what the degree of flexion should be in a lateral projection of the knee when there is a new or unhealed patellar fracture. 9. Describe the interspace between the patella and the femoral condyles if the lateral projection of the knee is correct. 10. Identify the PA and AP oblique projections of the knee which demonstrates the head of the fibula and the proximal tibiofibular articulation. 11. Explain the significance of weight-bearing AP projections of the knees when checking for arthritis. 12. Define the terms varus, valgus, and osteotomy. 13. Contrast the examination of bilateral arthritic knees with that for unilateral examination in terms of centering the CR and weight-bearing. 14. State the three methods that can be used to demonstrate the intercondyloid fossa and which ones are AP projections or PA projections which are superoinferior projections of inferosuperior projections. 15. State which method of intercondyloid fossa demonstration will give a more open view of the fossa. 16. Describe the relation of the CR to the long axial of the tibia (leg) for demonstration of the intercondyloid fossa using the Camp-Coverntry method; using the Be clere method; using the Holmblad method. 17. State the point of centering of the CR for all three methods of intercondyloid fossa examination. 18. State three pathologic conditions of the knee which may be shown with a intercondyloid fossa projection. 19. Explain the rationale for a PA projection of the patella as opposed to an AP projection. 20. State why the heel is rotated 5 to 10 degrees laterally in the PA projection of the patella. 21. State what can be done to the patient to help relieve pain when positioned for a PA projection of the patella.

12 22. State the prime objective in demonstrating the patella using the Kuchendorf method. 23. Describe why caution should be taken in flexing the knee for a tangential (Settegast method) projection of the patella. 24. Describe the variations in body position tht can produce a tangential projection of the patella. 25. State the traditional term used to denote a tangential projection of the patella; an intercondyloid fossa projection. 26. State the purpose of tangential projections of the patella. Femur-Pelvis and Upper Femora (B, C, D, F) 75% Minimum Mastery Level Required 1. Be able to discuss or answer questions concerning the following positioning considerations: (All positions of the Femur and Pelvis and Upper Femora) a. part position (examples AP, lateral axiolateral) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 2. When given a drawing skeletal part, or radiograph of the femur or pelvis and upper femora, label or locate the following bones and identify bones which articulate: a. femur (proximal and distal aspect) 1) head 2) greater trochanter 3) lesser trochanter 4) neck 5) shaft 6) medial epicondyle 7) medial condyle 8) lateral epicondyle 9) lateral condyle 10) intercondylar fossa 11) fovea capitis 12) intertrochanteric crest and line b. pelvis 1) ilium a) iliac crest b) posterior superior and inferior spine c) anterior superior and inferior spine d) ala e) body 2) ischium a) spine of ischium b) inferior and superior ramus c) ischium tuberosity 3) pubis a) inferior and superior ramus of pubis b) symphysis pubis 4) general a) greater sciatic notch b) lesser sciatic notch c) obturator foramen d) acetabulum (ilium, ischium and pubis) e) sacrum f) sacroiliac joints 5) hip joint (ball-and-socket joint)

13 a) acetabulum (os coxae or os innominatum) b) femoral head 3. Identify the two bony points of localization for the hip joint. 4. Describe the method of localizing the long axis of the femoral neck and hip joint. 5. Describe the structural differences of the pelvis with stature and with sex. 6. Define false pelvis; true pelvis. 7. Define inlet of true pelvis and describe the measurement for it. 8. Define outlet of true pelvis and describe the measurement for it. 9. Identify the bony palpable landmarks used in radiography of the pelvis and hips. 10. Identify the spinal interspace or disk space at the level of the iliac crest. 11. Identify the sacral segment at the level of the anterior superior iliac spine. 12. Identify the structures of the pelvis at the level of the highest point of the greater trochanter. 13. Identify the structure of the pelvis at the level of the most prominent point of the greater trochanter. 14. Explain the importance of including one or both joints on radiographs of the extremities. 15. Explain the need to invert the foot 15 degrees on studies of the femur or pelvis. 16. State the average anterior and superior angle the average adult femoral neck will form. 17. Describe radiation protection techniques to be used when examining the femur or upper femora and pelvis. 18. Describe the difference in lower extremity (leg) placement when radiographing the femur in the lateral position to include the knee as opposed to the hip. 19. Describe the variation in exposure factors when performing projections of the femur bucky as opposed to nonbucky. 20. Explain the objective of two projections of the pelvis, one with a perpendicular CR and one with a 45 degree cephalic angulation of the CR, for demonstration of the relationship of the femoral head to the acetabulum in patients with congenital dislocation of the hip. 21. Describe the leg placement and central ray angulation for studies of the femoral necks using Cleave s method. 22. Associate the term frog with the Cleave s method of femoral neck examination. 23. Describe an exact lateral position of the pelvis relative to acetabular shadows and femoral heads. 24. Explain what precautions should be taken when performing a Frog lateral of the hip, and when an axiolateral projection should be performed. 25. Explain the significance of using a large enough film to include the entire pelvic girdle and upper femora when doing the initial examination of a hip. 26. Explain when inversion of the foot in hip or pelvis studies is contraindicated. 27. Explain the need diagnostically for examining the hip both in the AP and lateral projections. 28. Explain the special precautions that must be taken when using a stationary grid. 29. In studies of the anterior pelvic bones (AP axial projection) contrast angulation of the CR for male and female patients. 30. Compare the AP axial projection of the anterior pelvic bones (Taylor method) with the AP axial projection (Lilienfeld method). 31. Associate the PA axial projection (Staunig method) with being the reverse (exact duplicate) of the AP axial projection (Litienfeld method). 32. Associate the PA projection of the anterior pelvic bones with being the reverse (exact duplicate) of the AP axial projection (Taylor method). Medical Terminology (I, K) 75% Minimum Mastery Level Required A. Respiratory System 1. Define the anatomical terms of the respiratory system. 2. Give the definitions of the word parts included in this chapter. 3. Build, analyze, define, pronounce, and spell the diagnostic terms related to the respiratory system. 4. Define, pronounce, and spell other diagnostic terms related to the respiratory system. 5. Build, analyze, define, pronounce, and spell the surgical terms related to the respiratory system. 6. Build, analyze, define, pronounce, and spell the diagnostic procedural terms related to the respiratory system. 7. Build, analyze, define, pronounce and spell additional terms related to the respiratory system. 8. Define, pronounce, and spell the other additional terms related to the respiratory system. Bony Thorax (A, B, C, D, E, F) 75% Minimum Mastery Level Required 1. Be able to discuss or answer questions concerning the following positioning considerations: (All positions of the sternum, sternoclavicular articulations, and ribs).

14 a. part position (examples AP, PA oblique, lateral) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 2. When given a drawing, skeletal part, or radiograph of the sternum or bony thorax, label or locate the following bones and identify bones which articulate. a. sternum and sternoclavicular joints 1) manubrium (articulates with clavicle and 1 st costal cartilage) 2) gladiolus (body) (articulates with costal cartilage 3 rd -7 th ) 3) xiphoid (ensiform) 4) sternal angle (articulation of manubrium and gladiolus) (articulates with 2 nd costal cartilage) 5) suprasternal notch (superior border of manubrium) b. ribs 1) head-articulates with vertebral bodies to form costovertebral joints(1 st, 10 th, 11 th, and 12 th ribs each articulates with one vertebral body) 2) neck 3) tubercle (articulates with the transverse process of a thoracic vertebra to form costotransverse articulations except in the 11 th and 12 th ribs) 4) shaft 5) anterior, posterior, and axillary aspect c. sternoclavicular joints 1) sternal ends of clavicles 2) clavicular notches of the manubrium A. Sternum 1. State the rationale for using the RAO position for sternal radiography as opposed to 1) the LAO position and 2) the PA position. 2. State the rationale for using breathing motion in radiographic examination of the sternum in the frontal projection. 3. Explain the use of deep inhalation for radiographic examination of the sternum in the lateral position. 4. Explain the reason for rotating the shoulders posteriorly and having the patient lock his hands behind his back in radiographic examinations of the sternum in the lateral projection. 5. Identify the circumstance when it may be necessary to examine the sternum in the horizontal ray (cross-table) lateral projection. B. Sternoclavicular Articulations 1. Identify the spinous process of the 3 rd thoracic vertebra as the point to center the CR to the manubrial notch or the sternoclavicular articulations. 2. State the rationale for asking the patient to turn his head to face the affected side when unilateral radiographic examination of the sternoclavicular is done. 3. Describe the benefit of using a short focus-film-distance in the radiographic examination of the sternoclavicular joints in the PA projection. 4. Explain the reason for radiographic examination of the sternoclavicular joints in the oblique projections. 5. Identify the problem associated with radiographic examination of the sternum in an oblique projection using the CR angulation method. 6. State the benefit of using the CR angulation method of sternal examination. 7. State the rationale for the placement of the shoulders in the radiographic examination of the sternoclavicular joint in the lateral position (Kurzbauer method). 8. State the rationale for 1) exposure at the end of full inhalation and 2) 15 degree caudad angulation of the CR in the radiographic examination of the sternoclavicular joint in the lateral projection. C. Ribs 1. State the projection which should be done to demonstrate the following: a. anterior aspect of the ribs

15 b. axillary aspect of the ribs c. posterior aspect of the ribs d. costal joints 2. State the appropriate AP or PA oblique position of the body for radiographic demonstration of 1) the right axillary aspect of the ribs; 2) the left axillary aspect of the ribs. 3. Explain the reason for suspension of respiration at the end of deep exhalation for ribs below the diaphragm and at the end of full inhalation for ribs above the diaphragm. 4. Explain the reason for an oblique projection to demonstrate the axillary aspect of the ribs. 5. State the rationale for high centering of the CR when the 7 th, 8 th, and 9 th ribs are to be demonstrated. 6. State the angle, centering point and direction of the CR for radiographic examination of the costovertebral and costotransverse joints. Chest (B, C, D, E, F) - 75 % Mastery Level Required 1. Be able to discuss or answer questions concerning the following positioning considerations: (All positions of the chest). a. part position (examples AP, PA, lateral, obliques, lordotic) b. structure(s) visualized and functions demonstrated d. film / screen combination used e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 2. When given a drawing, anatomic section, or radiograph of the chest, label or locate the following structures: a. right lung 1) upper lobe 2) middle lobe 3) lower lobe b. left lung 1) upper lobe 2) lower lobe c. heart d. trachea e. hilum 1) left main bronchus 2) right main bronchus f. base g. apex h. diaphragm 3. State the radiographically important structures contained in the mediastinum. 4. Describe the appearance of an acceptable PA and lateral chest radiograph. 5. Explain the reason for positioning the arms to rotate the scapulae laterally in an AP / PA projection of the chest. 6. State the reasons for performing chest radiography erect, 72 inches (FFD). 7. Explain why exposures should be made on the second full inspiration. 8. Describe which lateral projection should be routinely taken of the chest. 9. State the reasons for examination of the chest at the end of both inhalation and exhalation. 10. State the level at which the CR must be centered 1) for the lungs; 2) for the heart or aorta. 11. Describe the method of image evaluation which identifies rotation of the chest in the 1) PA / AP projection; 2) in the lateral projection 12. Explain the variation in body rotation and centering of the central ray when the heart is examined in the RAO and LAO positions. 13. Explain the reason for asking a woman with large, pendulous breast to pull them upward and laterally before an exposure of the chest in the AP / PA projection is made. 14. Explain the significance of a correctly penetrated heart when doing chest radiography.

16 15. Compare the image of a PA projected chest radiograph with an AP projected radiograph of the chest. 16. Identify the left PA oblique projection as the reverse duplicate of the right AP oblique projection; likewise, identify the right PA oblique projection as corresponding to the left AP oblique projection by listing the structures shown in each projection. 17. State the main problem in evaluating the pulmonary apices in the routine PA / AP projection of the chest. 18. Describe the position of the clavicles relative to the apices of the lungs using the following projections: a. PA axial (CR 10 to 15 degrees cephalad - on inhalation) b. PA (on exhalation) c. AP axial (on full inhalation 15 to 20 degrees cephalad) d. AP or PA lordotic 19. Describe the body position known a extreme lordosis. 20. Explain how placing the body in extreme lordosis can aid in the radiographic demonstration of the apices of the lungs. 21. State two pathologic conditions which may be demonstrated using the lordotic projection. 22. Describe the position of the body and the direction of the CR for the following projections: a. lateral decubitus b. ventral decubitus c. dorsal decubitus 23. State the view(s) obtained when the following projections are done: a. lateral decubitus b. vental decubitus c. dorsal decubitus 24. Explain how fluid level or air will determine which lateral decubitus projection will be performed. 25. Explain how the lateral decubitus projections may be used to identify aspiration of a nonopaque foreign body. Abdomen (B, C, D, E, F) - 75% Minimum Mastery Level Required 1. Be able to discuss or answer questions concerning the following positioning considerations: (Basic projections of the abdomen) a. part position (examples AP, DUB, lateral, oblique, upright, decubitus) b. structure(s) visualized and functions demonstrated d. film / screen combination e. film size / placement / identification / markers f. beam alignment / angulation g. beam limitation / shielding h. patient instructions 2. When given a diagram, anatomic torso or radiograph of the abdomen, identify the following structures: a. iliac crest b. anterior superior iliac spine c. greater trochanter d. symphysis pubis e. liver f. pancreas g. kidneys h. spleen i. gallbladder j. small intestine (bowel) k. large intestine (colon) l. stomach m. right and left major psoas muscle n. diaphragm 3. State the anatomical relationship between the greater trochanter and the symphysis; the crest of the ilium and the lumbar vertebrae. 4. Describe the location of the following relative to 1) external palpable bony landmarks; 2) the four quadrants of the abdomen, and 3) the nine regions of the abdomen: a. liver

17 b. gallbladder c. kidneys d. spleen e. stomach f. ureter g. bladder h. small intestine i. colon 5. Describe basic patient preparation for the abdomen. 6. Define KUB. 7. List the four quadrants of the abdomen; list the nine regions of the abdomen. 8. Explain how size, shape, position, tonus, and motility of the internal organs of the abdomen are determined by body form of habitus. 9. Define the following terms and explain their significance to radiography of abdominal organs. a. hypersthenic b. sthenic c. hyposthenic d. asthenic 10. Define peristalsis. 11. Explain how voluntary motion is identified in a radiographic examination of the abdomen; involuntary motion. 12. State which projection should be performed when the patient is unable to sit up or stand for an upright abdomen. 13. State why the patient should remain upright or lying on his/her left side for 10 minutes or more before an upright or left lateral decubitus is performed. 14. Explain the need to include the diaphragm on an upright examination of the abdomen. 15. Explain why the left lateral decubitus projection is done of the abdomen when the possibility of intraperitoneal gas is being investigated. 16. State the routine projections taken when an acute abdomen series is ordered. 17. Define acute abdomen. 18. State the radiographic significance of a PA, erect chest to include the diaphragm when investigating the possibility of intraperitoneal gas. Medical Terminology (I, K) - 75% Minimum Mastery Level Required A. Digestive System 1. Define the anatomical terms of the digestive system. 2. Write the definitions of the word parts included in this chapter. 3. Build, analyze, define, pronounce, and spell the diagnostic terms related to the digestive system. 4. Define, pronounce, and spell other diagnostic terms related to the digestive system. 5. Build, analyze, define, pronounce, and spell surgical terms related to the digestive system. 6. Define, pronounce, and spell other surgical terms related to the digestive system. 7. Build, analyze, define, pronounce and spell the diagnostic procedure terms related to the digestive system. 8. Define, pronounce, and spell other procedural diagnostic terms related to the digestive system. 9. Build, analyze, define, pronounce, and spell additional terms related to the digestive system. 10. Define, pronounce, and spell the other additional terms related to the digestive system. Anatomy of Vertebral Column (A, E, F) 75% Minimum Level Required 1. Name the five major groups of vertebrae and state the number of vertebrae normally found in each group. 2. Define the following terms: a. lordotic curve b. kyphotic curve c. primary curve d. secondary or compensatory curve e. scoliosis 3. Differentiate the lumbar-pelvic curve of a male with the lumbar-pelvic curve of a female. 4. Describe the two types of joints found in the vertebral column and identify the joints which represent each type. 5. State the four types of movements permitted in the vertebral column and describe each movement.

18 6. Given a diagram, anatomic structures or radiograph, identify and / or locate the following parts of a typical vertebra: a. body b. vertebral arch c. vertebral canal d. pedicles e. laminae f. spinous process g. apophyseal joints h. superior / inferior articulating facets i. transverse processes j. vertebral foramina 7. Associate the term atlas with the first cervical vertebra and the term axis with the second cervical vertebra. 8. Compare and contrast the first cervical (atlas) with the other cervical vertebrae and the vertebral segments in general. 9. Compare the contrast the second cervical (axis) with the other cervical vertebrae and the vertebral segments in general. 10. Differentiate the typical cervical vertebra from the rest of the vertebrae in the vertebral column. 11. Compare and contrast the seventh cervical vertebra (vertebra prominens) with other cervical vertebra. 12. Identify the radiographic projection which will best demonstrate the following structures of the cervical vertebrae: a. cervical bodies (AP) (lateral) b. transverse processes (AP) c. spinous processes (lateral) d. apophyseal joints (lateral) e. intervertebral foramina (oblique) f. pedicles (lateral, oblique) g. laminae (oblique, pillar) h. intervertebral disc (AP, lateral, oblique) 13. Compare and contrast the typical thoracic vertebra from the rest of the vertebrae in the vertebral column. 14. Define the following: a. demifacet b. facet c. costovertebral joint d. costotransverse joint 15. Identify the radiographic projection which will best demonstrate the following structures of the thoracic vertebrae: a. thoracic bodies (AP, lateral) b. transverse process (AP) c. spinous process (lateral) d. apophyseal joints (oblique) e. intervertebral foramina (lateral) f. pedicles (lateral) g. costovertebral / costotransverse joints (AP0CR toward head) h. laminae (AP superimposed and tomography) 16. Compare and contrast the typical lumbar vertebra from the rest of the vertebrae in the vertebral column. 17. Identify the radiographic projection which will best demonstrate the following structures of the lumbar vertebrae: a. lumbar bodies (AP, lateral) b. transverse processes (AP) c. spinous process (lateral) d. apophyseal joints (oblique) e. intervertebral foramina (lateral) (1-4 only) f. pedicles (lateral) g. laminae (oblique and AP superimposed) h. L-5 / S-1 intervertebral foramen (oblique, axial) 18. Differentiate the male sacrum from the female sacrum.

19 19. Explain the purpose of intervertebral foramina and sacral foramina. 20. Given a diagram, anatomic model, or radiograph, identify and / or locate the following parts of the sacrum and occyx: a. body (sacrum) b. sacral promontory (sacrum) c. ala (sacrum) d. articular surface for articulation with iliac bone (sacrum) e. sacral cornua f. coccygeal vertebrae g. coccygeal cornua h. sacral canal Medical Terminology (I, K) 75% Minimum Mastery Level Required A. Cardiovascular and Lymphatic System 1. Define the anatomical terms of the cardiovascular and lymphatic systems. 2. Give the definitions of the word parts included in this chapter. 3. Build, analyze, define, pronounce, and spell the diagnostic terms related to the cardiovascular and lymphatic systems. 4. Define, pronounce, and spell other diagnostic terms related to the cardiovascular and lymphatic systems. 5. Build, analyze, define, pronounce, and spell the surgical term related to the cardiovascular and lymphatic systems. 6. Define, pronounce, and spell other surgical terms related to the cardiovascular and lymphatic systems. 7. Build, analyze, define, pronounce, and spell the diagnostic procedural terms related to the cardiovascular and lymphatic systems. 8. Define, pronounce, and spell other diagnostic procedural terms related to the cardiovascular and lymphatic systems. 9. Build, analyze, define, pronounce, and spell additional terms related to the cardiovascular and lymphatic systems. 10. Define, pronounce, and spell the other additional terms related to the cardiovascular and lymphatic systems. Occipitocervical Articulations (B, C, D) 75% Minimum Mastery Level Required 1. Be able to discuss or answer questions concerning the following positioning considerations: AP oblique or bilateral PA projection a. part position (examples AP, oblique, lateral or other) b. structure(s) visualized and function(s) demonstrated d. film / screen combination used e. film size / placement / identifications / markers f. beam angulation and alignment to part and film g. beam limitation / shielding h. patient instructions 2. Explain the evaluation criteria used to determine the accuracy of positioning when radiographing the L or R occipitocervical articulation unilaterally. 3. In the AP oblique projection of the occipitocervical articulation, identify the articulation which is demonstrated (the one closer or farther from the film). 4. Describe the evaluation criteria used to determine the accuracy of positioning when radiographing the occipitocervical articulations bilaterally. 5. Given a diagram, anatomic model, or radiograph, identify and / or locate the following: a. occipital condyle b. superior facets (atlas) Atlas and Axis (B, C, D) 75% Minimum Mastery Level Required 1. Be able to discuss or answer questions concerning the following positioning considerations: a. part position (examples AP, oblique, lateral or other) b. structure(s) visualized and function(s) demonstrated